Mitral Repair With Complete Rings or Posterior Bands in Barlow Disease: Long-term Results

BACKGROUND Complete rings or posterior bands are both commonly used during mitral valve repair, but which one ensures the best long-term outcome in patients with Barlow disease is a topic of debate. This study evaluated whether the type of annuloplasty device affects the long-term durability of the repair. METHODS We selected 296 consecutive patients with severe mitral regurgitation due to Barlow disease who under-went edge-to-edge mitral repair at our institution between 2004 and 2013. For the edge-to-edge repair, a complete semirigid ring was used in 151 patients, whereas a posterior flexible band was used in 145 patients. The clinical and echocardiographic outcomes of both groups were compared at long-term follow-up. RESULTS At 14 years, the overall survival was 87.3% +/- 2.79% in the ring group and 94.1% +/- 2.30% in the band group (P = .056). The incidence of mitral valve reintervention was 4.9% +/- 1.95% in the ring group and 5.5% +/- 2.53% in the band group (P = .371) at 14 years. The incidence of recurrence of mitral regurgitation double dagger 3+ and double dagger 2+ was 8.3% +/- 2.64% in the ring group and 8.7% +/- 3.07% in the band group (P = .991) and 26.5% +/- 4.23% in the ring group and 17.4% +/- 3.26% in the band group (P = .697), respectively. Mitral regurgitation double dagger 1+ at discharge was the only independent predictor of reoperation and recurrence of mitral regurgitation double dagger 3+ in the long-term. CONCLUSIONS In patients with Barlow disease undergoing edge-to-edge mitral valve repair, the type of annuloplasty device does not influence the long-term results. Achieving an optimal immediate result remains the key to maintain the stability of the repair at long-term.